Recurrent Urosepsis Following Stent Removal for Ureteral Stones: A Case Report

TL;DR

A woman had two urosepsis episodes after stent removal for kidney stones, showing the need for better imaging and careful stent use.

Contribution

Highlights the risk of urosepsis after stent removal and the importance of improved imaging for residual stones.

Findings

Urosepsis occurred twice after stent removal despite no residual stones seen in initial imaging.

Further imaging during hospitalization revealed missed stone fragments and hydronephrosis.

The case suggests a need for better imaging and cautious stent use to reduce infection risk.

Abstract

Urosepsis, a severe infection originating from the urinary tract, can be life-threatening. We present the case of a 56-year-old female who developed urosepsis twice within 15 days, each episode occurring shortly after stent removal. Ureteroscopy with stent placement was initially performed to treat a 12-mm stone in the distal left ureter. Although the stent was removed only after imaging showed no residual stones, sepsis developed shortly after, leading to another ureteroscopy and stent placement. Before the removal of the second stent, imaging again confirmed no stones were present, yet she experienced sepsis once more following the second stent removal. Further imaging studies during hospital admission for both episodes of sepsis revealed stone fragments and hydronephrosis which were missed during office evaluations. This case highlights the need for more effective imaging techniques to detect residual stones. The decision to place a stent after ureteroscopy for ureteral stone treatment should also be carefully considered, even for low-risk patients, to reduce infection risk.

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